DESCRIPTION: (Provided by the Applicant) The proposed study extends our current experimental investigation on Translating Research into Practice (TRIP) to examine sustainability of the current TRIP intervention, and to further test interventions to promote and sustain evidence-based practice (EBP) changes. Acute pain management of hospitalized older adults is the clinical EBP topic. Specific aims are: 1. To examine the natural history (decay effect) of the current, multifaceted TRIP intervention, on physicians' and nurses' acute pain management practices for hospitalized elders, 18 months after implementing the intervention. 2. To test the effect of a modified TRIP intervention on promoting adoption, by physicians and nurses, of acute pain management practices for hospitalized elders. 3. To test the effect of the modified TRIP intervention on decreasing barriers to use of evidence-based acute pain management practices for hospitalized elders. 4. To test the effects of a TRIP sustainability intervention, initiated after cessation of the modified TRIP intervention, on the nurses' and physicians' acute pain management practices for hospitalized elders. 5. To examine the relationship between organizational variables, and the extent of adoption by nurses and physicians, of evidence-based practices for acute pain management of hospitalized elders. 6. To determine the cost-effectiveness ratios of the modified TRIP intervention and sustainability intervention. We will use the 12 hospitals in our current study for Aim 1. The 6 hospitals in our current study and two newly recruited sites will be used for Aims 2-6. This research will advance the science of TRIP, provide knowledge regarding sustainability of EBP changes, and improve our understanding of the relationship between organizational variables and extent of adoption of EBPs. The investigation further enhances relationships between investigators with expertise in TRIP, and hospitals responsible for care delivery.